Amid continuing uncertainty about the impact of deep US funding cuts to humanitarian work worldwide, the head of the UN agency coordinating the fight against HIV-AIDS warned that an addition 6.3 million people will die in the next four years, unless support is reinstated.
"We will see a …real surge in this disease - [we] will see it come back and we see people dying the way we saw them in the 90s and in 2000s," said Winnie Byanyima, UNAIDS Executive Director, pointing to a "tenfold increase" from the 600,000 AIDS-related deaths recorded globally in 2023.
"We also expect an additional 8.7 million new infections. At the last count, there were 1.3 million new infections globally (in) 2023".
Speaking in Geneva, Ms. Byanyima noted that the funding freeze announced by the White House on 20 January was due to end next month, after a 90-day review.
"We have not heard of other governments pledging to fill the gap," she told journalists.
Already, drop-in centres where HIV patients can pick up the anti-retroviral medicines they need are not reopening, "for fear that this might not be consistent with the new guidelines", she maintained.
"This sudden withdrawal of US funding has led (to) shutting down of many clinics, laying off of thousands of health workers, these are nurses, doctors, lab technicians, pharmacy workers…it's a lot."
Focus on Africa
Focusing on Africa - where the east and south of the continent share 53 per cent of the global HIV burden - Ms. Byanyima warned that closing down "all of a sudden drop-in centres for girls and young women will be disastrous, because more than 60 per cent of new infections - amongst young - new infections on the continent are amongst girls and young women".
Speaking to UN News earlier this month, the head of the UNAIDS office in the Democratic Republic of the Congo (DRC), Susan Kasedde, said there were still major questions over the extent and scope of cuts due to be made to US PEPFAR initiative programmes, which began in 2003 to prevent and contain HIV infections - the presidency's emergency plan which has saved an estimated 26 million lives.
There are currently around 520,000 people living with HIV in the DRC, including 300,000 women and 50,000 children. The epidemic continues to grow, as the number of new infections is almost double the number of deaths linked to the disease.
PEPFAR's expected contribution for the 2025 fiscal year was due to be $105 million, and it aims to provide treatment half of the population living with HIV in the DRC - some 209,000 people.
"This means that we currently have 440,000 people living with HIV who are on treatment. Thanks to this treatment, they are alive", said Ms. Kasedde.
"And then treatment cannot work without operational capacity, treatment cannot be provided if there is not a proper-functioning supply chain", she stressed, pointing out that the response to HIV in the DRC involve largely interdependent programmes which reinforce each other.
Global impact of cuts
Several other UN agencies that are heavily reliant on US funding have also warned that the cut in support - in addition to chronic under-investment in humanitarian work globally - is already having a serious impact on the communities they serve.
On Friday, the UN refugee agency, UNHCR , said that thousands have been left without lifesaving aid in the war-torn eastern Democratic Republic of the Congo.
The UN International Organization for Migration ( IOM ) also announced that funding cuts have severe repercussions for vulnerable migrant communities, exacerbating humanitarian crises and undermining essential support systems for displaced populations.
Together with IOM, the UN Children's Fund ( UNICEF ) warned last Friday that that the liquidity crunch has jeopardized lifesaving work, including progress in reducing child mortality, which has fallen by 60 per cent since 1990.
"It is reasonable for the United States to want to reduce its funding - over time. But the sudden withdrawal of lifesaving support is having a devastating impact across countries, particularly Africa, but even in Asia and Latin America," said UNAIDS' Ms. Byanyima.
"We urge for a reconsideration and an urgent restoration of services - of life-saving services."
Presidential appeal
And in a direct appeal to President Donald Trump, the UNAIDS chief noted that just as President George W Bush had introduced the groundbreaking PEPFAR initiative, the new White House incumbent could also be part of the "prevention revolution", involving injectable HIV injections that are required just twice a year to provide protection.
"The deal is that an American company is enabled to produce and to license generics across the regions to produce millions and roll out this injectable to those who really need it," she insisted.
According to UNAIDS, approximately 40 million people globally live with HIV, based on 2023 data. Of this number, some 1.3 million became newly infected with HIV in the same year and 630,000 people died from AIDS-related illnesses.
